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目的:比较低温等离子消融与常规切除方式在内镜经鼻翼腭窝鳞状细胞癌手术中的疗效差异。方法:回顾性分析解放军总医院耳鼻咽喉头颈外科收治并实施鼻内镜手术的38例上颌窦鳞状细胞癌侵犯翼腭窝患者的临床资料,根据肿瘤切除方式的不同分为低温等离子组与常规手术组。比较2组平均手术时间、出血量、手术并发症、住院天数及术区愈合时间。结果:手术均相对彻底切除了上颌窦、翼腭窝肿瘤。低温等离子组与常规手术组的平均手术时间分别为(244.00±62.86)min和(294.17±73.49)min,平均术中出血量分别为(481.50±426.43)ml和(790.00±387.34)ml,平均住院天数分别为(16.75±4.45)d和(19.89±4.84)d,平均术区愈合时间分别为(8.35±1.31)周和(9.61±2.20)周,2组差异均有统计学意义(P<0.05);手术并发症发生率分别为0和11%,术后3年复发率分别为34.3%和49.4%,2组差异均无统计学意义(P>0.05)。结论:应用低温等离子刀切除病灶相对于常规手术方式具有切除效率高、术中出血少、术后恢复快等优势,其安全、微创的特点已使之成为鼻颅底手术中重要的辅助工具。
Objective: To compare the efficacy of low temperature plasma ablation and conventional resection in endoscopic transnasal pterygopalatine squamous cell carcinoma. Methods: The clinical data of 38 patients with maxillary sinus squamous cell carcinoma infiltrating the pterygopalatine fossa admitted to Department of Otorhinolaryngology Head and Neck Surgery of PLA General Hospital were retrospectively analyzed. According to the different tumor resection methods, Surgery group. The mean operation time, blood loss, operative complications, hospitalization days and operative healing time were compared between the two groups. Results: The surgery was relatively complete removal of the maxillary sinus, pterygopalatine tumors. Mean operative time of the low-temperature plasma group and the conventional surgery group were (244.00 ± 62.86) min and (294.17 ± 73.49) min, respectively. The mean intraoperative blood loss was (481.50 ± 426.43) ml and (790.00 ± 387.34) ml, respectively, The average healing time was (8.35 ± 1.31) weeks and (9.61 ± 2.20) weeks, respectively, with significant difference between the two groups (P <0.05) ). The complication rates were 0 and 11% respectively. The recurrence rates at 3 years after surgery were 34.3% and 49.4% respectively. There was no significant difference between the two groups (P> 0.05). Conclusion: The removal of lesions by low-temperature plasma knife has the advantages of high removal efficiency, less bleeding during operation and faster recovery after surgery compared with conventional surgical methods. The safety and minimally invasive features have made it an important auxiliary tool for nasal skull base surgery .